Can depression cause extreme fatigue

SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

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    It's Not Your Fault (NACoA) (PDF | 12 KB)
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    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
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    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).



  • Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
  • Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31. 4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily


  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism



  • In 2020, 20. 7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
  • Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3.4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals


  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program


  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes



  • Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose


  • Medication-Assisted Treatment
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program


  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network



  • In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.


  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.


  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 01/05/2023

How does depression affect your well-being?

Each of us has heard the word "depression". But do we fully understand what it is? Let's try to understand the essence of this disease and how it affects our psychological and physical well-being.


  • What is depression?
  • Symptoms of depression: psychological state
  • Symptoms of depression: physical condition
  • How can a mental disorder cause pain?
  • Why does depression occur and who is at risk?
  • How to make a diagnosis?
  • How to treat?

What is depression?

In many people's minds, the word "depression" is synonymous with bad mood and depression. To some extent this corresponds to the truth, but in reality everything is much more complicated.

Depression, or major depressive disorder, is an illness that causes persistent feelings of sadness, loss of interest in life, and a host of other symptoms. It affects how a person feels, thinks and behaves and can lead to a variety of both emotional and physical problems. It is important to understand that depression is a serious mental disorder that requires treatment and observation by a specialist, and not to be confused with other problems.

For example, constant fatigue and unwillingness to get out of bed in the morning may indicate a lack of vitamins, iron, magnesium or other trace elements.

Although it is possible to take tests for the level of these substances on your own, you should not do this: it will be better if the necessary checks are prescribed and carried out by a doctor - this will save you unnecessary anxiety and expenses.

If you feel bad, experience negative emotions and do not find strength for everyday activities, then this is also not a reason to immediately suspect depression. It is likely that the lowering of mood is a reaction to severe stress or bad events that have occurred in your life. Experts point out the following differences between "natural" negative emotions and depression:

  1. If a strong grief has occurred in a person's life (for example, the death of a loved one), then painful feelings come in waves, often mixed with positive memories. With depression, the mood and interest in life are constantly reduced, for two or more weeks.
  2. In severe sadness or grief, a person's self-esteem is at the same level, and in depression, feelings of worthlessness and self-loathing are common.
  3. In severe grief, thoughts of one's own death may appear sporadically when a person thinks about "joining" with a deceased loved one. In a depressive disorder, such thoughts arise from a sense of the meaninglessness of one's life or from an inability to cope with problems.

In any case, the symptoms of true depression are not limited to those listed above. They can be divided into psychological and physical.

Symptoms of depression: psychological state

Symptoms of depression affecting the psychological state of a person include:

● Feelings of sadness, hopelessness, emptiness.
● Outbursts of anger and irritability even for minor reasons.
● Loss of interest and pleasure in activities that normally bring joy (sports, hobbies, meeting loved ones).
● Attacks of anxiety, agitation, nervousness.
● Feelings of worthlessness or guilt, obsession with past failures.
● Problems with concentration and memory.
● Recurrent thoughts about one's own death, attempts to hurt oneself or otherwise harm oneself.

In children and adolescents, psychological symptoms are generally the same as those listed above, but they may be accompanied by a decrease in school performance, unwillingness to attend classes, avoidance of communication with classmates and friends, tearfulness.

Symptoms of depression: physical condition

The physical manifestations of depressive disorder include the following symptoms:

● Sleep disorders: insomnia or drowsiness.
● Constant fatigue and lack of energy, due to which even ordinary daily activities (cleaning, showering) require significant physical effort.
● Disorders of appetite: its decrease or, conversely, its increase. The result is weight loss or gain.
● Pain that occurs for no apparent reason.
● Convulsions.
● Digestive problems.

How can a mental disorder cause pain?

Experts say that disturbances in the normal functioning of the body and pain of unknown origin - that is, occurring without an apparent physical cause - are often a symptom of depression. Pain can occur in the joints, in the limbs, in the back and head; in addition, a person may experience problems with the gastrointestinal tract, fatigue, sleep and appetite disorders, changes in psychomotor activity.

Experts say that both types of symptoms are related - the more pain, the more severe the depressive disorder. In addition, pain can be a kind of "indicator" - according to one study, which studied data from more than 1,000 people diagnosed with depression from 14 countries, 69% of patients first came to the doctor because of unclear pain and other physiological problems. This connection between pain and depression can interfere with diagnosis: first, the doctor, of course, will send the patient with a headache or indigestion for further specialized examinations, but if they do not show anything, and the doctor does not have enough knowledge, he may not suspect depression and be in a diagnostic impasse.

Why is this happening? Physical pain and depression have a deep biological connection. In our body there are biologically active substances called neurotransmitters - they transmit electrochemical impulses from nerve cells and neurons to muscles and other cells of the body. Neurotransmitters that affect both pain and mood include serotonin and norepinephrine.

Changes in the function and effect of these neurotransmitters, and how they interact with neurons and nerve cells involved in maintaining mood stability, may play an important role in depression.

The reasons why neurotransmitters start to work "wrong" are very complex, and scientists continue to investigate them.

Why does depression occur and who is at risk?

According to experts, women are more susceptible to depression than men, and the median age of onset is 32 years (this means that half of the people who receive a diagnosis of depression in their lifetime will already have their first depressive episode by this age) . However, this is all - experts cannot give a more detailed portrait of a “typical patient”, because anyone can become a victim of the disease.

However, there are a number of factors that increase the risk of developing a depressive disorder:

  1. Genetics. Depression can be inherited: studies show that genetics can contribute up to about 40% to the development of depression, and the likelihood that the twin of a person suffering from depression will also receive this diagnosis is about 70%. In 2019, scientists conducted a meta-analysis of data on more than 800 thousand people and found 102 genetic variants associated with the development of depression.
  2. Environmental factors. If a person has experienced severe stress or psychological trauma in his life (for example, a child had a difficult childhood, he was subjected to violence, lived in conditions of extreme poverty), then the likelihood of developing a depressive disorder increases.
  3. Personal qualities of a person. People with low self-esteem, easily succumbed to stress, and prone to pessimism are at greater risk.
  4. Hormonal changes due to pregnancy, postpartum, menopause, and thyroid disorders.
  5. Other serious health problems: Parkinson's disease, diabetes, heart disease, cancer.

How to make a diagnosis?

Not only the well-being of a person, but also his life can depend on the correct diagnosis and timely treatment. To diagnose a depressive disorder, doctors must conduct a set of tests.

  1. First of all, a psychiatrist should talk to a person about his state of health, thoughts, behavior. The patient may be asked to fill out a special questionnaire that contains various signs of depression. For a diagnosis to be made, the patient must experience a certain amount of these symptoms for two or more weeks over most of the day.
  2. General medical examination to find out whether the pain or other disturbances of the body - of course, if present - are of a physical nature.

How to treat?

Despite the seriousness of the disease, do not despair when making a diagnosis. Depressive disorder is treated using different methods:

  1. Antidepressants - these drugs affect the biochemical processes in the brain, the work of neurotransmitters. It is important to know that antidepressants may not have an effect for several weeks after the start of treatment - the patient may not notice improvement within 2-3 months. Sometimes the doctor is not immediately able to choose the right dosage or drug, in addition, antidepressants can have side effects, so they should never be taken on their own, without prescription and constant monitoring by the doctor.
  2. Psychotherapy. In cases of mild depression, psychotherapy can be used as the main treatment, in more severe cases, in addition to antidepressants. Usually, specialists use cognitive behavioral therapy - it is focused on helping a person to focus on the present, solve current problems, recognize thoughts and behavior distorted by depression and correct them. This treatment may take several weeks or months.
  3. Depression is usually treated with medication and psychotherapy. But in extremely severe cases, when the previous treatment has not helped, the method of electroconvulsive (or electroconvulsive) therapy can be used. The patient is under anesthesia, and doctors perform short-term stimulation of his brain with an electric current.
  4. Another relatively new treatment for depression is transcranial magnetic stimulation (impact on the cerebral cortex using magnetic pulses), but research on its effectiveness has not yet been completed.
  • Mayo Clinic, Depression (major depressive disorder), 2018
  • National Institute of Mental Health, Depression, 2018
  • Mayo Clinic, Pain and depression: Is there a link? 2019
  • Nature Reviews, Major depressive disorder, 2016
  • The Primary Care Companion to The Journal of Clinical Psychiatry, The Link Between Depression and Physical Symptoms, 2004
  • Web MD, Depression and Chronic Pain, 2021
  • The New England Journal of Medicine, An international study of the relation between somatic symptoms and depression, 1999
  • American Psychiatric Association, What Is Depression? 2020

How to get rid of chronic fatigue and depression? Treatment of depression in the Central Medical Health Center "Alliance"

The frantic pace of city life, the desire for material well-being and climbing the career ladder at the cost of rest and favorite activities turn into chronic fatigue and depression.

Chronic fatigue, depression is a reason to seek help from a psychotherapist.

Exhausting everyday affairs do not bring a sense of satisfaction and lead to depression; in a depressed mood, a person copes with things even worse. There is a non-disappearing fatigue, in the fight against which neither weekends nor vacations help. A person not only cannot continue things as before, the nervous system is exhausted, a mental disorder begins.

It is impossible to rely on chance in such a situation - the disease will not go away on its own. To defeat them in time, seek help from an experienced specialist.

How does the disorder manifest itself?

Fatigue and constant lethargy are some of the signs of depression. With constant depression and fatigue, a person feels lethargy and indifference to everything, cannot concentrate, and has no strength for anything.

Symptoms of the disorder include:

  • weakness, which even after rest and sleep is not replaced by activity;
  • pain that covers the whole body, discomfort;
  • poor sleep, slow falling asleep and frequent awakenings, not feeling sleepy in the morning and daytime sleepiness;
  • increased anxiety;
  • frequent colds.

In the case of depression, a person is tormented by rapid fatigue, a negative vision of the future, and a constantly lowered mood.


Stress, overload and overstrain deplete the nervous system, it disrupts the exchange of neurotransmitters - for example, serotonin (the hormone of joy, pleasure). By itself, it recovers for a long time, you can speed up recovery with the help of antidepressants and psychotherapy.

Lack of appetite, lack of response to external circumstances in the family, at work, in society can be added to the symptoms of a mental disorder.

Mild depression can hide several mental disorders at once (dysthymia, bipolar affective disorder, cyclothymia), their treatment is different. Therefore, for a diagnosis, you need to contact a competent psychotherapist.

How to get rid of fatigue and depression?

Without timely treatment, symptoms can seriously damage family relationships, affect professional activities and relationships with friends.

Learn more